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Cortrosyn (cosyntropin) Disease Interactions

There are 20 disease interactions with Cortrosyn (cosyntropin):

Major

Acth (Includes Cortrosyn) ↔ (+) Tuberculin Test

Severe Potential Hazard, High plausibility

Applies to: Tuberculosis -- Latent, History - Tuberculosis

In patients with latent tuberculosis or tuberculin reactivity, the use of pharmacologic dosages of adrenocorticotropic agents may cause a reactivation of the disease. Close monitoring for signs and symptoms of tuberculosis is recommended if adrenocorticotropic therapy is administered to these patients. During prolonged use, tuberculosis chemoprophylaxis may be considered.

References

  1. "Product Information. Acthrel (corticorelin)." Ferring Laboratories Inc, Tarrytown, NY.
  2. "Product Information. Cortrosyn (cosyntropin)" Organon, West Orange, NJ.
  3. "Product Information. Acthar (corticotropin)." Rhone-Poulenc Rorer, Collegeville, PA.
Major

Acth (Includes Cortrosyn) ↔ Adrenal Insufficiency

Severe Potential Hazard, High plausibility

Applies to: Adrenal Insufficiency

The use of adrenocorticotropic agents is contraindicated in patients with primary adrenocortical insufficiency because of the lack of adrenal responsiveness.

References

  1. "Product Information. Acthar (corticotropin)." Rhone-Poulenc Rorer, Collegeville, PA.
  2. "Product Information. Acthrel (corticorelin)." Ferring Laboratories Inc, Tarrytown, NY.
  3. "Product Information. Cortrosyn (cosyntropin)" Organon, West Orange, NJ.
Major

Acth (Includes Cortrosyn) ↔ Electrolyte Imbalance

Severe Potential Hazard, Moderate plausibility

Applies to: Hypocalcemia, Hypernatremia, Hypokalemia, Seizures

Adrenocorticotropic agents may cause hypernatremia, hypokalemia, hypocalcemia, and fluid retention. Therapy with these agents, particularly if intended for longer than brief periods, should be administered cautiously in patients with preexisting electrolyte disturbances. Caution is also advised when treating patients with seizure disorders, since electrolyte disturbances may trigger seizure activity.

References

  1. "Product Information. Acthar (corticotropin)." Rhone-Poulenc Rorer, Collegeville, PA.
  2. "Product Information. Acthrel (corticorelin)." Ferring Laboratories Inc, Tarrytown, NY.
  3. "Product Information. Cortrosyn (cosyntropin)" Organon, West Orange, NJ.
Major

Acth (Includes Cortrosyn) ↔ Gi Perforation

Severe Potential Hazard, Moderate plausibility

Applies to: Intestinal Anastomoses, Diverticulitis, Ulcerative Colitis

Adrenocorticotropic agents may cause gastrointestinal perforation and hemorrhage, usually when given in high dosages or for prolonged periods. They may also mask symptoms of complications such as peritonitis or intraabdominal sepsis. Therapy with adrenocorticotropic agents should be administered cautiously in patients with diverticulitis, nonspecific ulcerative colitis (if there is a probability of impending perforation, abscess, or other pyogenic infection), or recent intestinal anastomoses.

References

  1. "Product Information. Acthrel (corticorelin)." Ferring Laboratories Inc, Tarrytown, NY.
  2. "Product Information. Cortrosyn (cosyntropin)" Organon, West Orange, NJ.
  3. "Product Information. Acthar (corticotropin)." Rhone-Poulenc Rorer, Collegeville, PA.
Major

Acth (Includes Cortrosyn) ↔ Infections

Severe Potential Hazard, High plausibility

Applies to: Infection - Bacterial/Fungal/Protozoal/Viral

The immunosuppressant and anti-inflammatory effects of adrenocorticotropic agents, particularly in higher dosages, may decrease host resistance to infectious agents, decrease the ability to localize infections, and mask the symptoms of infection. Secondary infections may be more likely to develop. In general, adrenocorticotropic agents should not be used in patients with active infections, especially systemic fungal infections, unless they are medically necessary and effective antimicrobial therapy or other appropriate treatment has been instituted. For patients who have received prolonged adrenocorticotropic therapy who develop a severe or life-threatening infection, supplemental doses of rapid-acting corticosteroids may be required, since these patients may have hypothalamic-pituitary insufficiency.

References

  1. "Product Information. Acthar (corticotropin)." Rhone-Poulenc Rorer, Collegeville, PA.
  2. "Product Information. Acthrel (corticorelin)." Ferring Laboratories Inc, Tarrytown, NY.
  3. "Product Information. Cortrosyn (cosyntropin)" Organon, West Orange, NJ.
Major

Acth (Includes Cortrosyn) ↔ Ocular Herpes Simplex

Severe Potential Hazard, Moderate plausibility

Applies to: Ocular Herpes Simplex

Adrenocorticotropic agents should be used cautiously, if at all, in patients with ocular herpes simplex because of the risk of corneal perforation. The manufacturers consider their use to be contraindicated in such setting.

References

  1. "Product Information. Acthar (corticotropin)." Rhone-Poulenc Rorer, Collegeville, PA.
  2. "Product Information. Cortrosyn (cosyntropin)" Organon, West Orange, NJ.
  3. "Product Information. Acthrel (corticorelin)." Ferring Laboratories Inc, Tarrytown, NY.
Major

Acth (Includes Cortrosyn) ↔ Pud

Severe Potential Hazard, Moderate plausibility

Applies to: History - Peptic Ulcer, Peptic Ulcer

Adrenocorticotropic agents may cause peptic ulcer disease and gastrointestinal (GI) hemorrhage, usually when given in high dosages or for prolonged periods. Delayed healing of peptic ulcers has also been reported. Therapy with adrenocorticotropic agents, if necessary, should be administered cautiously in patients with active or latent peptic ulcers or other risk factors for GI bleeding. The manufacturers consider their use to be contraindicated in such setting.

References

  1. "Product Information. Cortrosyn (cosyntropin)" Organon, West Orange, NJ.
  2. "Product Information. Acthar (corticotropin)." Rhone-Poulenc Rorer, Collegeville, PA.
  3. "Product Information. Acthrel (corticorelin)." Ferring Laboratories Inc, Tarrytown, NY.
Major

Acth (Includes Cortrosyn) ↔ Scleroderma

Severe Potential Hazard, High plausibility

Applies to: Systemic Sclerosis

The use of adrenocorticotropic agents is contraindicated in patients with scleroderma. Adrenocorticotropic agents may precipitate renal crisis with malignant hypertension in these patients, possibly via steroid-induced increases in renin substrate and angiotensin II levels and decreases in vasodilator prostaglandin production. Renal failure may ensue. If treatment is required for inflammatory myositis or pericarditis, glucocorticoids are preferable because of their more predictable pharmacologic effect. However, glucocorticoids should also be avoided in the long-term treatment of patients with scleroderma for similar reasons.

References

  1. "Product Information. Acthar (corticotropin)." Rhone-Poulenc Rorer, Collegeville, PA.
  2. "Product Information. Acthrel (corticorelin)." Ferring Laboratories Inc, Tarrytown, NY.
  3. "Product Information. Cortrosyn (cosyntropin)" Organon, West Orange, NJ.
Moderate

Acth (Includes Cortrosyn) ↔ Cirrhosis

Moderate Potential Hazard, High plausibility

Applies to: Cirrhosis

Adrenocorticotropic agents may have enhanced effects in patients with cirrhosis. Dosage adjustments may be necessary in these patients.

References

  1. "Product Information. Acthrel (corticorelin)." Ferring Laboratories Inc, Tarrytown, NY.
  2. "Product Information. Cortrosyn (cosyntropin)" Organon, West Orange, NJ.
  3. "Product Information. Acthar (corticotropin)." Rhone-Poulenc Rorer, Collegeville, PA.
Moderate

Acth (Includes Cortrosyn) ↔ Depression/Psychoses

Moderate Potential Hazard, Moderate plausibility

Applies to: Psychosis, Depression

Adrenocorticotropic agents may aggravate the symptoms of psychosis and emotional instability. Patients with these conditions should be monitored for increased or worsened symptoms during adrenocorticotropic therapy.

References

  1. "Product Information. Acthar (corticotropin)." Rhone-Poulenc Rorer, Collegeville, PA.
  2. "Product Information. Acthrel (corticorelin)." Ferring Laboratories Inc, Tarrytown, NY.
  3. "Product Information. Cortrosyn (cosyntropin)" Organon, West Orange, NJ.
Moderate

Acth (Includes Cortrosyn) ↔ Diabetes

Moderate Potential Hazard, High plausibility

Applies to: Diabetes Mellitus, Abnormal Glucose Tolerance

Adrenocorticotropic agents may impair glucose tolerance and cause hyperglycemia. Therapy with these agents should be administered cautiously in patients with diabetes mellitus, glucose intolerance, or a predisposition to hyperglycemia. Patients with diabetes mellitus should be monitored more closely during adrenocorticotropic therapy, and their antidiabetic regimen adjusted accordingly.

References

  1. "Product Information. Cortrosyn (cosyntropin)" Organon, West Orange, NJ.
  2. "Product Information. Acthar (corticotropin)." Rhone-Poulenc Rorer, Collegeville, PA.
  3. "Product Information. Acthrel (corticorelin)." Ferring Laboratories Inc, Tarrytown, NY.
Moderate

Acth (Includes Cortrosyn) ↔ Elevated Iop

Moderate Potential Hazard, Moderate plausibility

Applies to: Glaucoma/Intraocular Hypertension

Prolonged use of adrenocorticotropic agents may cause elevated intraocular pressure and glaucoma with possible damage to the optic nerves. Long-term therapy with these agents should be administered cautiously in patients with preexisting glaucoma (particularly open-angle glaucoma) or increased intraocular pressure.

References

  1. "Product Information. Acthrel (corticorelin)." Ferring Laboratories Inc, Tarrytown, NY.
  2. "Product Information. Cortrosyn (cosyntropin)" Organon, West Orange, NJ.
  3. "Product Information. Acthar (corticotropin)." Rhone-Poulenc Rorer, Collegeville, PA.
Moderate

Acth (Includes Cortrosyn) ↔ Fluid Retention

Moderate Potential Hazard, Moderate plausibility

Applies to: Congestive Heart Failure, Fluid Retention, Hypertension, Renal Dysfunction

Adrenocorticotropic agents may cause hypernatremia, hypokalemia, fluid retention, and elevation in blood pressure. Therapy with these agents, particularly if intended for longer than brief periods, should be administered cautiously in patients with preexisting fluid retention or conditions that may be aggravated by these effects. Dietary sodium restriction and potassium supplementation may be advisable. The manufacturers consider the use of adrenocorticotropic agents to be contraindicated in patients with congestive heart failure or uncontrolled hypertension.

References

  1. "Product Information. Acthrel (corticorelin)." Ferring Laboratories Inc, Tarrytown, NY.
  2. "Product Information. Cortrosyn (cosyntropin)" Organon, West Orange, NJ.
  3. "Product Information. Acthar (corticotropin)." Rhone-Poulenc Rorer, Collegeville, PA.
Moderate

Acth (Includes Cortrosyn) ↔ Hyperadrenocorticism

Moderate Potential Hazard, High plausibility

Applies to: Hyperadrenocorticism

The use of adrenocorticotropic agents is contraindicated in patients with adrenocortical hyperfunction. These agents stimulate the release of cortisol and aldosterone and may aggravate symptoms of hyperadrenocorticism.

References

  1. "Product Information. Acthar (corticotropin)." Rhone-Poulenc Rorer, Collegeville, PA.
  2. "Product Information. Cortrosyn (cosyntropin)" Organon, West Orange, NJ.
  3. "Product Information. Acthrel (corticorelin)." Ferring Laboratories Inc, Tarrytown, NY.
Moderate

Acth (Includes Cortrosyn) ↔ Hypothyroidism

Moderate Potential Hazard, Moderate plausibility

Applies to: Hypothyroidism

Adrenocorticotropic agents may have enhanced effects in patients with hypothyroidism. Dosage adjustments may be necessary in these patients.

References

  1. "Product Information. Cortrosyn (cosyntropin)" Organon, West Orange, NJ.
  2. "Product Information. Acthrel (corticorelin)." Ferring Laboratories Inc, Tarrytown, NY.
  3. "Product Information. Acthar (corticotropin)." Rhone-Poulenc Rorer, Collegeville, PA.
Moderate

Acth (Includes Cortrosyn) ↔ Myasthenia Gravis

Moderate Potential Hazard, High plausibility

Applies to: Myasthenia Gravis

While corticotropin has been used effectively in severe, refractory myasthenia gravis to increase muscle strength, it should nevertheless be administered with extreme caution in such setting. Patients must be treated in an intensive care unit and receive respiratory support, since muscle strength will markedly decrease initially. Improvement usually occurs several days after the first or second course of treatment. Similar responses might be expected of other adrenocorticotropic agents, although their use in myasthenia gravis has not been studied extensively.

References

  1. "Product Information. Cortrosyn (cosyntropin)" Organon, West Orange, NJ.
  2. "Product Information. Acthrel (corticorelin)." Ferring Laboratories Inc, Tarrytown, NY.
  3. "Product Information. Acthar (corticotropin)." Rhone-Poulenc Rorer, Collegeville, PA.
Moderate

Acth (Includes Cortrosyn) ↔ Myopathy

Moderate Potential Hazard, High plausibility

Applies to: Myopathy, Myoneural Disorder

Toxic myopathy may occur with the prolonged use of adrenocorticotropic agents, often in patients with disorders of neuromuscular transmission such as myasthenia gravis or in patients receiving neuromuscular blocking agents. Steroid myopathy is generalized and sometimes accompanied by respiratory weakness and dyspnea. In some cases, it has resulted in quadraparesis. Elevations of creatine kinase may also occur, albeit infrequently. After withdrawal of ACTH therapy, recovery may be slow and incomplete. Therapy with adrenocorticotropic agents should be administered cautiously in patients with preexisting myopathy or myoneural disorders, since these conditions may confound the diagnosis of steroid-induced myopathy. The presence of a normal serum CK level, minimal or no changes of myopathy on EMG, and type 2 muscle fiber atrophy on biopsy are helpful in suggesting steroid-induced weakness. If steroid myopathy is suspected, a dosage reduction or discontinuation of adrenocorticotropic therapy should be considered.

References

  1. "Product Information. Acthrel (corticorelin)." Ferring Laboratories Inc, Tarrytown, NY.
  2. "Product Information. Acthar (corticotropin)." Rhone-Poulenc Rorer, Collegeville, PA.
  3. Hardman JG, Gilman AG, Limbird LE eds. "Goodman and Gilman's the Pharmacological Basis of Therapeutics. 9th ed." New York, NY: McGraw-Hill (1995):
View all 5 references
Moderate

Acth (Includes Cortrosyn) ↔ Osteoporosis

Moderate Potential Hazard, High plausibility

Applies to: Osteoporosis

Adrenocorticotropic agents inhibit the absorption of intestinal calcium and increase urinary excretion of calcium, which can result in bone resorption and bone loss during prolonged therapy. In addition, bone matrix may be affected by the protein-catabolic effects of these agents, especially when given in high dosages or for prolonged periods, leading to aseptic necrosis and fractures. Long-term or high-dose adrenocorticotropic therapy should be administered cautiously and only if necessary in patients with or at risk for osteoporosis. The manufacturers consider the use of adrenocorticotropic agents to be contraindicated in such setting.

References

  1. "Product Information. Acthar (corticotropin)." Rhone-Poulenc Rorer, Collegeville, PA.
  2. "Product Information. Acthrel (corticorelin)." Ferring Laboratories Inc, Tarrytown, NY.
  3. "Product Information. Cortrosyn (cosyntropin)" Organon, West Orange, NJ.
Moderate

Acth (Includes Cortrosyn) ↔ Thromboembolism

Moderate Potential Hazard, Low plausibility

Applies to: Thrombotic/Thromboembolic Disorder, History - Thrombotic/Thromboembolic Disorder

Adrenocorticotropic agents may increase blood coagulability and have rarely been associated with the development of intravascular thrombosis, thromboembolism, and thrombophlebitis. These agents should be used cautiously in patients with thrombotic or thromboembolic disorders.

References

  1. "Product Information. Cortrosyn (cosyntropin)" Organon, West Orange, NJ.
  2. "Product Information. Acthar (corticotropin)." Rhone-Poulenc Rorer, Collegeville, PA.
  3. "Product Information. Acthrel (corticorelin)." Ferring Laboratories Inc, Tarrytown, NY.
Moderate

Acth (Includes Cortrosyn) ↔ Vaccination

Moderate Potential Hazard, High plausibility

Applies to: Vaccination

The administration of live or live, attenuated vaccines is contraindicated in patients receiving large or immunosuppressive doses of adrenocorticotropic agents. Inactivated viral or bacterial vaccines should be used with caution, since their administration may pose a risk of neurological complications in these patients. Additionally, a diminished or inadequate serum antibody response may be anticipated.

References

  1. "Product Information. Acthar (corticotropin)." Rhone-Poulenc Rorer, Collegeville, PA.
  2. "Product Information. Acthrel (corticorelin)." Ferring Laboratories Inc, Tarrytown, NY.
  3. "Product Information. Cortrosyn (cosyntropin)" Organon, West Orange, NJ.

Cortrosyn (cosyntropin) drug Interactions

There are 475 drug interactions with Cortrosyn (cosyntropin)

Cortrosyn (cosyntropin) alcohol/food Interactions

There is 1 alcohol/food interaction with Cortrosyn (cosyntropin)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.

Do not stop taking any medications without consulting your healthcare provider.

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